Individual
TRENT DUANE MADSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2910 E BATTLEFIELD ST, SPRINGFIELD, MO 65804-4016
(417) 444-6776
Mailing address
2910 E BATTLEFIELD ST, SPRINGFIELD, MO 65804-4016
(417) 444-6776
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2020014879
MO
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/27/2020
Last updated
10/04/2022
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